Five minutes past trauma

A new series of ABC Radio National’s All in the Mind has just kicked off with a thoughtful programme about treating traumatised people just after a tragic event.

If you’re not familiar with the contentious area of disaster response, you may be surprised to hear that there is no firm evidence that psychological treatment of just-traumatised people is any more helpful in the long-term than doing absolutely nothing.

This is in contrast to the widely held belief that all disaster victims ‘need’ to see mental health professionals. In fact, studies on psychological treatment in disaster victims have suggested the worrying result that some treatments may actually make matters worse in the long-term for some people.

This was famously found in studies on single session ‘debriefing’ but also less well known is that there is a similar conclusion with regard to multi-session psychological treatment that is aimed to prevent trauma in disaster victims.

To complicate matters, in thestudies where the effects are shown to be harmful in the long-term, patients reported feeling better immediately after the sessions.

If you are a psychologist responding to a disaster, grateful and apparently relieved patients are extremely strong personal evidence that you are being helpful, even if in the long-term you might be causing problems.

This makes it very hard for some to accept that they need to question what they are doing.

But there is one over-arching and important point that trauma psychologist Richard Bryant makes in the programme – that, despite some good hints, the evidence is still not firm enough to say for sure whether we are helping, harming or being irrelevant when working with just-traumatised victims.

It must be stressed that this is in contrast to treating people who are still traumatised a long while after an incident and haven’t recovered on their own, where we know psychological treatment is helpful and important.

This issue of All in the Mind is a fantastic discussion of the potential benefits and drawbacks of ‘trauma debriefing’ and immediate psychological treatment and don’t miss some great additional material on the blog.

Link to AITM on ‘The mind in crisis’.Link to additional material and audio on the AITM Blog.